Active NPI
Kevin James Knutson, DDS, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Madison, WI
National Provider Identifier
1770820755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 6838-15
- Practice address
- 202 S Gammon Rd
Suite 150
Madison, WI 53717-1400 - Phone
- (608) 664-9500
- Fax
- (608) 664-9566
- NPI assigned
- Jan 10, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 6838-15 | WI | Primary |
Addresses
Primary practice location
202 S Gammon Rd
Suite 150
Madison, WI 53717-1400
Mailing address
202 S Gammon Rd
Suite 150
Madison, WI 53717-1400
Phone (608) 664-9500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6838-15 | WI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthodontic Specialists of Madison | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Madison, WI
- NPI 1275667149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424649600000",
"number": "1770820755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 S GAMMON RD",
"address_2": "SUITE 150",
"city": "MADISON",
"state": "WI",
"postal_code": "537171400",
"telephone_number": "608-664-9500",
"fax_number": "608-664-9566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 S GAMMON RD",
"address_2": "SUITE 150",
"city": "MADISON",
"state": "WI",
"postal_code": "537171400",
"telephone_number": "608-664-9500",
"fax_number": "608-664-9566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUTSON",
"first_name": "KEVIN",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-10",
"last_updated": "2015-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "WI",
"license": "6838-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.